“Doctors and hospitals must put children’s health ahead of ideology and financial gain,” HHS Secretary Robert F. Kennedy, Jr. said via press release. “This report identifies troubling billing practices that demand scrutiny. HHS will follow the evidence, protect taxpayers, and hold accountable anyone who broke the law or violated the trust of patients and families.”

The report alleges that pediatric gender clinics and hospitals “used misleading or potential fraudulent diagnostic and procedural codes” to secure insurance coverage for transgender medical treatments for children, including surgical interventions such as mastectomy and vaginoplasty.

Between 2015 and 2025, the authors argue there was a significant rise in the use of the diagnostic codes for “endocrine disorder, unspecified” and “precocious puberty,” a rare condition that triggers puberty starting before the age of 8.

While puberty blockers are an appropriate treatment for precocious puberty, the report outlines that gender medicine clinics nationwide have used the precocious puberty diagnosis for patients ages 13 to 17, indicating potential insurance fraud.

Over the past decade, physicians used the diagnostic code “endocrine disorder, unspecified” to prescribe puberty blockers to 239 patients to the tune of nearly $42.6 million, according to the report. But many of those puberty blockers could have been used to treat gender dysphoria, not endocrine disease.

Most of these claims were paid by commercial insurance, but nearly $7.8 million was paid by Medicaid, the public insurance program that covers low-income families and children.

The authors also argue the low revenue of most pediatrics departments in hospitals incentivized the proliferation of youth gender medicine clinics, which effectively create repeat customers.

The World Professional Association of Transgender Health’s standards of care recommend that patients on hormone therapies, including puberty blockers and supplemental estrogen or testosterone, receive blood work checks every three to six months alongside annual bone density scans and multidisciplinary team assessments into adulthood.

Each step in this process, the authors note, marks “billable encounters, prescriptions, and facility fees” as revenue for hospitals or physician groups.

“They promised a new stream of continuous revenue for pediatrics, endocrinology, and surgical specialties by taking physiologically healthy young people — who otherwise would not need to seek medical attention, and rendering them dependent for life on the medical system,” the authors argue.

The report itself is likely to receive pushback from mainstream medical organizations that support transgender medical drugs and surgeries for minors, in part because of its authorship.

The document was authored by several members of the Independent Women’s Forum, a women’s rights group that opposes transgender medicine for minors. Two researchers from the Ethics and Public Policy Center, a Christian policy group that opposes youth gender medicine, are also listed as authors. 

Dr. Eithan Haim, who leaked patient records of gender medicine at Texas Children’s Hospital in Houston as a whistleblower, also co-authored the report alongside Dr. Quentin Van Meter, a pediatric endocrinologist who is outspoken against transgender procedures for minors.

When asked about the professional backgrounds of the authors, a spokesperson for HHS told the Washington Examiner that the credentials of the authors “speak for themselves: decades of clinical practice, academic appointments, extensive publication, and testimony before legislative bodies.”

“This is about protecting America’s children,” the spokesperson said. “HHS commissioned independent, third-party experts to bring outside expertise and rigorous scrutiny to an issue with profound consequences for children and families. The contributors bring substantial experience across medicine, law, public policy, government, communications, and journalism.” 

Since January 2025, the White House anti-fraud task force has uncovered roughly $230 billion in estimated fraud, including more than $96 billion from programs administered by HHS

HHS FINALIZES END TO MEDICAID FUNDING FOR CHILD SEX CHANGE PROCEDURES

HHS also announced earlier this week a finalized rule that will prohibit Medicaid reimbursement for sex change medicine for minors, including hormones and surgeries. 

The new rule is scheduled to take effect in October.